Complaint Investigation Report

Based on LPA's record review, facility is not following their mitigation plan submitted to the department. Facility had knowledge of first COVID positive result on 11/8/2021 but did not report to Community Care Licensing (CCL) until 11/12/2021. LPA identified facility is not following mitigation plan based on interview with Licensee. Designated staff (Licensee Arlene Wing) failed to report COVID case to CCL . Facility is not following staff and visitation screening prior to entering the facility. Facility did not have required postings identified in mitigation plan and they are not conducting survelance per mitigation plan, and they are not wearing PPE as identified in mitigation plan.

LPA provided licensee provider informational notices after technical assistance visit on 11/23/2021

The preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. California Code of Regulations, (Title 22, Division 6, Chapter 8), is being cited on the attached LIC 9099D. Appeal Rights Given.